Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2018/08/stewardship-resistance-scan-aug-06-2018
Stewardship / Resistance Scan for Aug 06, 2018
Phased stewardship strategy; Antibiotic use in the Amazon
Filed Under:
Antimicrobial Stewardship
[h=3]Study shows benefits of phased approach for implementing stewardship[/h] Researchers with a large community hospital system report that a phased approach for implementation of antibiotic stewardship programs was associated with significant clinical and financial benefits.
The study, published in the American Journal of Infection Control, describes the efforts of the Hospital Corporation of America (HCA) to implement a stewardship initiative in its network of 178 community hospitals in 20 states. The HCA Antimicrobial Management Program (AMP) was implemented in four phases?preparatory work, foundational work, clinical care optimization, and stewardship refinement?with individual facilities needing to meet goals before moving to the next phase. Surveys were distributed to the hospitals in 2010 (pre-implementation), 2015 (mid-implementation), and 2017 (post-implementation) to assess progress.
The results or the surveys showed that stewardship activities improved in most areas of the HCA AMP initiative in 2015, with substantial improvement by 2017. Among the highlights were the increase in established stewardship programs at individual hospitals, from 82% in 2010 to 88% in 2015 and 96% in 2017. In addition, programs with physician champions increased from 73% in 2010 to 94% in 2017, prospective audit and feedback programs increased from 58% in 2010 to 83% in 2017, and tracking of antibiotic use metrics rose from 54% in 2010 to 100% in 2017. Total antibiotic cost per adjusted patient day fell by 40% from the 2010 baseline.
The authors conclude that these improvements have helped build momentum for the larger goals of better patient outcomes, reduced morbidity and mortality, prevention or slowing of the emergence of antimicrobial resistance, and reduced healthcare expenditures.
Aug 3 Am J Infect Control study
[h=3]Researchers find inappropriate antimicrobial use in remote Amazon region[/h] A new study in PLoS One suggests that inappropriate antibiotic use is occurring in even the remotest places.
A team of Brazilian and Spanish researchers conducted the population-based cross-sectional study among riverside dwellers in the Amazon Basin. The riverside dwellers live in isolated communities with a poor health infrastructure and limited access to urban areas. The study looked specifically at the population of the Coari municipality, located in Amazonas state in the central Amazon region, with the researchers interviewing and collecting information on antimicrobial use among 492 riverside dwellers.
The investigators found that 346 of those surveyed (70.3%) had taken at least one medication in the previous month, and 74 (21.4% of those taking a medication, 15.0% of the entire study population) used an antimicrobial. In addition, 49 of the patients taking an antimicrobial (66.2%) obtained it without a prescription, and 32.5% of the antimicrobials consumed were for a non-infectious or non-bacterial disease. Respondents reported that antimicrobials such as amoxicillin, ampicillin, and tetracycline were consumed for symptoms such as "gut inflammation," "pain," and "flu."
The researchers say the findings highlight the need for specific public health policies in the region regarding the appropriate use of antimicrobials.
Aug 3 PLoS One study
Stewardship / Resistance Scan for Aug 06, 2018
Phased stewardship strategy; Antibiotic use in the Amazon
Filed Under:
Antimicrobial Stewardship
[h=3]Study shows benefits of phased approach for implementing stewardship[/h] Researchers with a large community hospital system report that a phased approach for implementation of antibiotic stewardship programs was associated with significant clinical and financial benefits.
The study, published in the American Journal of Infection Control, describes the efforts of the Hospital Corporation of America (HCA) to implement a stewardship initiative in its network of 178 community hospitals in 20 states. The HCA Antimicrobial Management Program (AMP) was implemented in four phases?preparatory work, foundational work, clinical care optimization, and stewardship refinement?with individual facilities needing to meet goals before moving to the next phase. Surveys were distributed to the hospitals in 2010 (pre-implementation), 2015 (mid-implementation), and 2017 (post-implementation) to assess progress.
The results or the surveys showed that stewardship activities improved in most areas of the HCA AMP initiative in 2015, with substantial improvement by 2017. Among the highlights were the increase in established stewardship programs at individual hospitals, from 82% in 2010 to 88% in 2015 and 96% in 2017. In addition, programs with physician champions increased from 73% in 2010 to 94% in 2017, prospective audit and feedback programs increased from 58% in 2010 to 83% in 2017, and tracking of antibiotic use metrics rose from 54% in 2010 to 100% in 2017. Total antibiotic cost per adjusted patient day fell by 40% from the 2010 baseline.
The authors conclude that these improvements have helped build momentum for the larger goals of better patient outcomes, reduced morbidity and mortality, prevention or slowing of the emergence of antimicrobial resistance, and reduced healthcare expenditures.
Aug 3 Am J Infect Control study
[h=3]Researchers find inappropriate antimicrobial use in remote Amazon region[/h] A new study in PLoS One suggests that inappropriate antibiotic use is occurring in even the remotest places.
A team of Brazilian and Spanish researchers conducted the population-based cross-sectional study among riverside dwellers in the Amazon Basin. The riverside dwellers live in isolated communities with a poor health infrastructure and limited access to urban areas. The study looked specifically at the population of the Coari municipality, located in Amazonas state in the central Amazon region, with the researchers interviewing and collecting information on antimicrobial use among 492 riverside dwellers.
The investigators found that 346 of those surveyed (70.3%) had taken at least one medication in the previous month, and 74 (21.4% of those taking a medication, 15.0% of the entire study population) used an antimicrobial. In addition, 49 of the patients taking an antimicrobial (66.2%) obtained it without a prescription, and 32.5% of the antimicrobials consumed were for a non-infectious or non-bacterial disease. Respondents reported that antimicrobials such as amoxicillin, ampicillin, and tetracycline were consumed for symptoms such as "gut inflammation," "pain," and "flu."
The researchers say the findings highlight the need for specific public health policies in the region regarding the appropriate use of antimicrobials.
Aug 3 PLoS One study